Outpatient health service utilization and associated factors: a population-based study

Rev Saude Publica. 2003 Jun;37(3):372-8. doi: 10.1590/s0034-89102003000300017. Epub 2003 Jun 3.

Abstract

Objective: To identify factors that lead people to visit a doctor in Brazil and assess differences between socioeconomic groups.

Methods: A cross-sectional study comprising 1,260 subjects aged 15 or more was carried out in southern Brazil. Demographic, socioeconomic, health needs and regular source of care data were analyzed concerning visits to a doctor within two months from the interview. Adjusted prevalence ratios and 95% confidence intervals were calculated using Poisson regression.

Results: Adjusted PR showed that women having stressful life events, health insurance, and a regular doctor increased the outcome. A dose-related response was found with self-reported health, and the probability of visiting a doctor increased with health needs. Analysis in the chronic disease group revealed that uneducated lower income subjects had a 62% reduction in the chance of visiting a doctor compared to uneducated higher income ones. However, as it was seen a significant interaction between income and education, years of schooling increased utilization in this group.

Conclusions: Results suggest the existence of health inequity in the poorest group that could be overcome with education. Specific measures reinforcing the importance of having a regular doctor may also improve access in the underserved group.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ambulatory Care / statistics & numerical data*
  • Brazil
  • Cross-Sectional Studies
  • Delivery of Health Care
  • Female
  • Health Services Accessibility
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Social Justice
  • Socioeconomic Factors